Only Saline with Transfusion?

[KKidd]

I have always been told that only 0.9%NACL should be run through the same tubing with blood/blood components. Are there any other compatible solutions? I cna't go into the details, but it involves an anesthesiologist.

:please::please:

[rrcc1974]

I found this chart

IV Solutions for Use with Blood Products

Acceptable for Use with Transfusion

Comments

0.9% saline

Only solution approved for direct mixing with blood

5% dextrose in 0.9% saline

Approved for rinsing IV tubing

5% dextrose in 0.45% saline

Approved for rinsing IV tubing

Unacceptable for Use with Transfusion

Reason

5% dextrose in water

Clumping and hemolysis

5% dextrose in 0.2% saline

RBC agglutination at room temperature, hemolysis at 37°

Lactated Ringer's solution

Clotting due to CA++ content

[David Saikin]

I have only seen normal saline as acceptable . . . rrcc - what is the etiology of your chart?

[rrcc1974]

David, that came from the Oregon Health & Science University website:

http://www.ohsu.edu/pathology/transman/adminbloodprod.html

I was surprised dextrose in saline was listed as acceptable for rinsing lines.

[LaraT23]

I also have only ever seen saline approved. I believe this is listed in a CAP standard if memory serves.

[rrcc1974]

Could it possibly be used to rinse the line of red cells in preparation for another fluid that would react adversely with residual red cells?

[rrcc1974]

Isotonic solutions:

http://www.cbbsweb.org/enf/1999_2000/solutions2blood.html

[Eoin]

Like other replies, you will find lists in standards and guidelines (BCSH for example). We limit to saline only here. We have found that supply any other list and exceptions tend to be forgotten leading to all sorts introduced into the line because of "CONVENIENCE" AS i WAS ONCE TOLD WHEN INVESTIATING A NON-CONFORMANCE.

cHEERS

eOIN

[Marilyn Plett]

According to the AABB Standards, you can use saline, solutions which are FDA-approved for addition to blood, and solutions for which there is adequate documentation.

[vilma_mt]

You can always refer to ....

http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/ucm080296.pdf

Every Transfusion Service should have a copy.

I think anybody who would like to attempt deviating from the guidance will think twice when you refer them to this site.

You might want to check if what your anesthesiologist is "doing" or "attempting to do" is FDA reportable.

[vilma_mt]

David, that came from the Oregon Health & Science University website:

http://www.ohsu.edu/pathology/transman/adminbloodprod.html

I was surprised dextrose in saline was listed as acceptable for rinsing lines.

Part of the Circular states....

"No medications or solutions may be routinely added to

or infused through the same tubing with blood or components

with the exception of 0.9% Sodium Chloride,

Injection (USP), unless a) they have been approved for

this use by the FDA or there is documentation available

to show that the addition is safe and does not adversely affect the blood or component."

I went to OHSU's website it does state "Approved for rinsing IV tubing".

[MsDuffy]

Normosol-R and Plasmalyte-A were approved by the FDA for utilization in blood transfusion, but it has been a few years since I read the package inserts for either product so I'd recommend reviewing a current package insert.